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General NPI Number Information
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NPI Number | 1346487097
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Entity Type | Individual
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Provider Name | MELISSA MARY SNYDER LPN
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Gender | Female
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Dates
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Enumeration Date | 01/17/2009
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Last Update Date | 01/17/2009
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Provider Practice Location Address
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Address Line | 14928 16 MILE RD
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City | LEROY
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State | MI
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Zip | 49655-8293
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Country | US
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Telephone | 231-768-4675
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Fax |
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Provider Business Mailing Address
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Address Line | 5965 N RAYMOND RD
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City | LUTHER
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State | MI
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Zip | 49656-9315
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Country | US
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Telephone | 231-357-3890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703096142
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License Number State | MI
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